Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware.
Department of Psychology, Rutgers University, New Brunswick, New Jersey.
J Pain. 2024 Sep;25(9):104583. doi: 10.1016/j.jpain.2024.104583. Epub 2024 May 31.
Racial disparities in pediatric pain care are prevalent across a variety of health care settings, and likely contribute to broader disparities in health, morbidity, and mortality. The present research expands on prior work demonstrating potential perceptual contributions to pain care disparities in adults and tests whether racial bias in pain perception extends to child targets. We examined the perception and hypothetical treatment of pain in Black and White boys (experiment 1), Black and White boys and girls (experiment 2), Black and White boys and adult men (experiment 3), and Black, White, Asian, and Latinx boys (experiment 4). Across this work, pain was less readily perceived on Black (vs White) boys' faces-though this bias was not observed within girls. Moreover, this perceptual bias was comparable in magnitude to the same bias measured with adult targets and consistently predicted bias in hypothetical treatment. Notably, bias was not limited to Black targets-pain on Hispanic/Latinx boys' faces was also relatively underperceived. Taken together, these results offer strong evidence for racial bias in pediatric pain perception. PERSPECTIVE: This article demonstrates perceptual contributions to racial bias in pediatric pain recognition. Participants consistently saw pain less readily on Black boys' faces, compared with White boys, and this perceptual bias consistently predicted race-based gaps in treatment. This work reveals a novel factor that may support pediatric pain care disparities.
儿科疼痛护理中的种族差异在各种医疗保健环境中普遍存在,并且可能导致更广泛的健康、发病率和死亡率方面的差异。本研究扩展了先前的工作,证明了成人疼痛护理差异中潜在的感知贡献,并测试了疼痛感知中的种族偏见是否延伸到儿童目标。我们研究了黑人和白人男孩(实验 1)、黑人和白人男孩和女孩(实验 2)、黑人和白人男孩和成年男性(实验 3)以及黑、白、亚洲和拉丁裔男孩(实验 4)对疼痛的感知和假设治疗。在这项工作中,黑人(而非白人)男孩的面部疼痛不太容易被感知到——尽管在女孩中没有观察到这种偏见。此外,这种感知偏见的程度与用成年目标测量的相同偏见相当,并一致预测了假设治疗中的偏见。值得注意的是,偏见不仅限于黑人目标——西班牙裔/拉丁裔男孩面部的疼痛也相对被低估。总的来说,这些结果为儿科疼痛感知中的种族偏见提供了强有力的证据。观点:本文证明了感知在儿科疼痛识别中的种族偏见中的作用。与白人男孩相比,参与者始终更容易看到黑人男孩面部的疼痛,而这种感知偏见一致地预测了基于种族的治疗差距。这项工作揭示了一个可能支持儿科疼痛护理差异的新因素。